Astragalus root, kidney failure, chemotherapy, immune boosting

Introducing Astragalus to a health meeting last week, I faced the additional task of educating the audience that we were not discussing Asparagus. Readers of this column became fascinated by Asparagus a few months ago following reports of its antioxidant, anti-inflammatory, anti-microbial and anti-cancer properties, especially of its cleansing and healing effects on the genito-urinary system.

With Astragalus coming up so soon after Asparagus, many people may become easily confused by these names. That is understandable. Even in the training seminars of the multi-level marketing companies, many distributors of their health products still get confused about arteriosclerosis and atherosclerosis. Lucky are those who are advised that arteriosclerosis is the hardening of blood vessels by calcium and other deposit in their soft muscles, a cause of hypertension. Lucky, also, are those who can distinguish atherosclerosis as blockage of the inner space of these blood vessels by cholesterol, homocystaine and other deposits, another possible cause of hypertension. Arteriosclerosis hardens the blood vessels and makes them not to dilate as they should when blood flows through them, increasing tension. Atherosclerosis reduces the space for blood to flow through, making the heart to pump blood with more force than it should, stressing the heart and possibly creating grounds for its enlargement.

In the case at hand, we must separate Astragalus from Asparagus as we do always separate arteriosclerosis from atherosclerosis.

Asparagus

Almost fat-less, loaded with folate, vitamin K, less endowed with other vitamins and minerals, and possessing no sodium, it helps bone density with vitamin K which helps calcium absorption into the bones, thereby helping to prevent fractures, especially of the hip bones, in elderly people. It is anti-inflammatory and antioxidant. For people who retain fluids, Asparagus is diuretic, cleans up the digestive system, frees it of constipation, thereby preventing colon cancer. The high level of follate (folic acid) supports pregnancy, encourages fetal growth and prevents neural tube and other defects and low birth way. Being an antioxidant, Asparagus can nail free radicals which are implicated in many cancers and other degenerative diseases. Accordingly, it is believed to protect the bone, breast, lungs, cervix, and colon against free radicals and the cancers they cause in those tissues. The growing rate of stress in all societies has led to a growth in the cases of depression. In stressful situations, the body produces inadequate amounts of Dopamine, Serotonin and Norepinephrine, hormones which help to stabilize the brain and keep the spirit high. As Asparagus supports the production of these hormones, it is seen as an anti-depressant herb. Studies suggest Asparagus reduces Cholesterol and Homocysteine levels and reduces blood sugar as well. There is a lot more to say of Asparagus. It beautifies the skin, balances female hormones and sorts out female problems, including a boosting of fertility, prevents kidney stones, knocks out hangovers, protects the eye, controls blood pressure, fights tuberculosis and epilepsy, checks internal bleeding and is a wonderful support for people who have challenges with their thyroid glands. We can go on and on…and on.

Astragalus Root

There are more than 2,000 species of Astragalus. But only two of them are used medicinally. Even then, it is their root that is used. Even then, still, there are harvested from Astragalus plants that are at least four years old. The medicinally useful Astragalus species are Astragalus membranaceus and Astragalus mongholicus.

Their roots do what Asparagus does…and more, fighting and breaking down tumours, boosting immunity, reducing the negative impact of Chemotherapy, making chemotherapy more effective, elongating the lives of some kidneys beset with kidney failure, especially those caused by the complications of diabetes, preventing collagen degradation (a cause of eye problems and blindness), wiping out viruses (HIV, Hepatitis et.c). European and American researchers agree that Astragalus is effective for a wide range of ailments but say there are not enough clinical studies on them to make fairly settled assertions. They say some of the studies on this herb are poorly designed, and, so, make such a valid statement difficult.

However, the Chinese who have used Astragalus for more than two thousand years to prevent and cure diseases do not consign themselves with clinical investigations as much as Euro-American researchers and physicians do, before they scientifically accept folk lore claims. While thinking about this column, I limited my self to three areas in which Astragalus root may be of benefits to radiant or ailing health, because of their prevalence in today’s Nigeria. These are Kidney health, lessening of chemotherapy side-effects and boosting of immunity. Kidney, Prostate and other uro-genital diseases are growing in number. Like the American Medical Association and the American Cancer Society which heavily supports chemotherapy and radiation for cancer treatment, the Nigerian Medical Association endorses these toxic therapies although they kill and severely maim many patients. Because many people do not eat well and live under stressful conditions, their internal hygiene is toxic and their immunity is poor, giving rise to an overgrowth of microorganisms, especially fungi, which have been implicated in cancers and other degenerative diseases. Any herb which supports kidney health, reduces chemotherapy side-effects and boost immunity among its many medicinal potentials, should be of high value to health in a society such as ours.

One of the investigations into Astragalus root use comes from PubMed Health which says:

“Chronic kidney disease affects increasing numbers of people around the world, but as yet effective strategies to control its progression has not been universally accepted. Astragalus is one of the most widely used herbs for treating kidney disease. We conducted this review to evaluate the benefits and potential harms of Astragalus for the treatment of people with chronic kidney disease.

“We searched the literature published for up to July 2004 and summarised 22 studies involving 1,323 people with chronic kidney disease, including both on dialysis treatment or not.

“Although we found some promising evidence suggesting that when given with conventional treatment, Astragalus may help to decrease the Serum Creatinine, reduce the amount of protein lost in the urine and diminish the effects of some complications, such as anaemia and malnutrition, evidence quality was low. We found that errors and omissions in study methods and reporting were likely to have flawed results among the studies we assessed. Possible adverse effects associated with Astragalus injection should be noted, although we had no relevant report from included studies.”

In Science Direct, we learn: “Several types of herbal preparation have been used as supplementary therapies for the treatments of progressive chronic kidney disease (CKD), but the scientific evidence for their use is scarce. The aim of the present study was to determine the effect of Astragalus membranaceus on renal outcome in patients with progressive CKD. The study population consisted of 35 patients with CKD stages 4 and 5 whose estimated glomerular filtration rate (eGFR) decreased over a 3-month period before the start of A membranaceus treatment despite the use of conventional therapy (from 14.6 ± 6.28 mL/min/1.73 m to 11.6 ± 5.24; mean ± SD, p < 0.05). Similarly, the eGFR of 15 patients with CKD stage 4 decreased over the same period despite conventional therapy (from 20.8 ± 4.59 to 16.7 ± 4.17; r = “1.298; p < 0.05), but increased after the initial period of 3 months of supplementary treatment with A membranaceus (to 18.6 ± 5.67; r = 0.973; p < 0.05) and remained at that level at 6 months (17.8 ± 5.60) and 12 months (16.3 ± 5.89).

“The results suggest that A membranaceus can maintain stable levels of eGFR and delay the initiation of renal replacement therapy in patients with progressive CKD stage 4.

“With increasing numbers of patients undergoing renal replacement therapy, the cost of chronic kidney disease (CKD) is rising worldwide. The number of patients requiring dialysis therapy in Japan has also increased almost linearly, about 10,000 a year, since surveys began in 1983, reaching 297,126 at the end of 2010. Therefore, it is important to establish strategies to delay the progression to end-stage kidney disease in CKD patients. However, despite significant advances in conventional medicine, no specific treatment is available for patients with stages 4 and 5 CKD. There is definitely a need for the use of combinations of different treatment modalities to control the progression of CKD, highlighting the importance of research on discovering new pharmacological agents for CKD. In Japan, not only traditional herbalists but also nephrologists have occasionally used herbal medicine for treatment of patients with CKD, including some imported from China, as part of combination therapy. Traditional herbalists usually prescribe a blend of several herbs such as Astragalus membranaceus, Angelica sinensis, Angelica acutiloba, Salvia miltiorrhiza , and rhubarb to patients with renal disease. Among these herbal medicines, formulations containing A membranaceus have often been used for renal disorders based on their diuretic action and reduction of proteinuria. In addition, A membranaceus is believed to have beneficial effects on other conditions such as diabetes mellitus and cardiovascular, digestive, hepatic, neurological, and allergic diseases. Several recent experimental studies using animal models of diabetic nephropathy and unilateral ureteral obstruction (UUO) renal fibrosis have highlighted the potency of A membranaceus. To our knowledge, however, there are only a few clinical case reports in the English literature on the effects of A membranaceus when used alone for membranous nephropathy.

“The objective of our prospective study was to assess the efficacy of A membranaceus in progressive CKD when used in combination with conventional therapy.

“As it is not randomised, we set up the primary endpoint to decline rate of eGFR before and after treatment with A membranaceus. Since several species of herbs are usually prescribed in combination, the present study is the first clinical trial on the use of A membranaceus alone.

“Of the 41 patients who were initially enrolled in this study, six were unable to continue treatment with A membranaceus for 3 months, and their data were excluded from the analysis. The reasons for cessation of treatment were revocation of consent ( n = 3), start of dialysis therapy ( n = 1), diarrhea ( n = 1), and change of hospital ( n = 1). Therefore, the study population eventually consisted of 35 patients (15 with CKD stage 4 and 20 with CKD stage 5) who were treated with A membranaceus daily for more than 3 months.”

(My apologies go to readers who may not have followed technical jargons in the study quoted above. The study was quoted for the benefit of our specialist doctors (Urologists) who read this column and are interested in incorporating herbal medicines into their practice.)

ALTHOUGH Western researchers and physicians are not definitive on the medicinal values of Astragalus root, especially in cancer treatment and immunity boosting, the Chinese are unrelenting in saying this herb has continued to work for them for thousands of years. Four of Western defenders of this herb are Michael McCulloch, Caylie See, Xiao-juan Shu, Michael Broffman, Alan Kramer, Wei-yu Fan, Jin Gao, Whitney Lieb, Kane Shieh, John M. Colford Jr. They put up a case for Astragalus root in jco.ascopubs.org saying in an abstract of their work:

“Systemic treatments for advanced non–small-cell lung cancer have low efficacy and high toxicity. Some Chinese herbal medicines have been reported to increase chemotherapy efficacy and reduce toxicity. In particular, Astragalus has been shown to have immunologic benefits by stimulating macrophage and natural killer cell activity and inhibiting T-helper cell type 2 cytokines. Many published studies have assessed the use of Astragalus and other Chinese herbal medicines in combination with chemotherapy. We sought to evaluate evidence from randomized trials that Astragalus-based Chinese herbal medicine combined with platinum-based chemotherapy (versus platinum-based chemotherapy alone) improves survival, increases tumor response, improves performance status, or reduces chemotherapy toxicity.”

The conclusion was: “we found evidence that Astragalus-best Chinese herbal medicine may increase effectiveness (by improving survival, tumour response, and performance status) and reduce toxicity of standard platinum-best chemotherapy for advanced non-small-cell lung cancer. However, affirmations of these conclusions in rigorously controlled, randomised trial is required before more firm conclusions about this therapy can be drawn.”

Immunity

Euro-American researchers and physicians become more dispassionate when death stares their communities in the face and their own brand of medicine has come to its wit’s end. The swine flu pandemic has brought Astragalus root to public limelight as an anti-viral and immune-boosting refuge. For thousands of years, the Chinese have used this herb for these purposes and more.

Nicholas Reavley tells us in the New Encyclopedia of Vitamins, Minerals, Supplements and Herbs:

“Astragalus is one of the best researched immune system stimulants now available. It works like Echinacea, in that both herbs increase the number and activities of immune cells. However, Astragalus concentrates on building the immune system and, unlike Echinacea, it can be taken on a daily bases. Echinacea boosts immune system activity and promotes fast recovery, especially when taken at the onset of symptoms. The most potent formula has a peculiar tingling and numbling effect on the tongue.

“Astragalus is another ancient Chinese herb that is frequently combined with Ginseng to strengthen the body’s natural defences, namely the immune system.

Cardiologist Stephen T., M.D., Sinatra says:

“Examples of popular adaptogenic herbs include Astragalus, Ravex, Ginseng, Siberian Ginseng, Lonicera, and Glycyrrhiza also known as Licorice root. They herb Astragalus has been researched thoroughly. Studies have revealed that Astragalus is quite effective in enhancing immune function and can be used to treat a wide variety of illnesses ranging from the common cold to cancer. Instead of directly attacking infectious organisms, Astragalus helps the body by fortifying the existing immune system.”